I know we’ve heard repeatedly about the high risk of infection and death among diabetics who develop COVID, so I was excited to see a new issue of Diabetes Care with studies focused specifically on Type 1’s.
Not the most informative, but:
https://care.diabetesjournals.org/content/43/8/e83?rss=1
That’s really interesting. Thanks for posting.
In a related vein, in the CDC’s June 20 update of risks associated with underlying conditions, diabetes is now broken out into type 2 and type 1. Type 2 is in the “are at increased risk” category, and type 1 is in the “might be at increased risk” category.
I saw that. Do you know what data is being used to justify that distinction?
The UK study I saw actually said people with type 1 had a higher hazard ratio than those with type 2. However they didn’t have enough data for the younger ages, so it seems like the conclusion could only apply to those above 50 (I think that was the age).
Here’s a link to the underlying data used and a bit more granularity on where each category stands based on the assessment:
“Strongest and most consistent evidence”.
“Mixed evidence” and
“limited evidence”
Type 2 is in the first category. Type 1 is in the last.
The CDC states this is a living document and will be updated as they learn more.
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/evidence-table.html
Thanks @JamesIgoe it’s always nice to get any tidbits of information with regards to type 1 and Covid.
I have been reading several short articles that they are pretty sure it has more to do with your actual control over blood sugars. And if you have more than one risk factor, it’s more of a problem. . A real prevalent risk factor is age and obesity. More concerning was it seems to be leaving more widespread damage to the heart even when you’ve completely recovered.
Thanks @Paytone I’m happy to see type 1 moved so far down the list. It does seem to be that if we get sick our BG’s go up and that becomes the danger with trying to control that and not ending up with DKA etc. And we all worry about how our immune systems will end up reacting.
I would suspect, given that COVID is a vascular disease, in both cases of T1 and T2, diabetes is functioning as a proxy for vascular health. T2 is more consistently associated with vascular health problems, so makes sense there’s a more robust risk factor there, whereas T1 increases risk of vascular damage as a complication, but it’s highly variable as to the extent of that damage among T1s. I would bet that while A1c/control is a predictor within T1, extent of microvascular and macrovascular complications or poor health might be an even stronger one. However, many diabetics do not realize they are experiencing microvascular damage in early states, so may be easier to use A1c/control again as a proxy for that.
As a T1D with (at this point well managed) proliferative retinopathy, I consider myself high risk, even though my current A1c is good. I think any of us with any history of vascular complications probably should, but that’s just based on my own best guess.
Very useful, and confirms what I would have guessed, but because they always use the blanket term “diabetes” as if it were synonymous with type 2 it’s really ambiguous what they’re saying. Do they mean me or not? I assume the distinction is because there are co-morbidities that track pretty consistently with type 2 that don’t with type 1. It is helpful to see the information separated out.
I did not see very much data in the first article and nothing about type 1 vs type2 and covid. It just seemed to list the symptoms of test pos cases and suspected cases. I was surprised that 1/3 went into dka, not surprised that 50% had high bg. It seems to go either way for me with illness, but usually I am normal or low. But I go very easily into dka, even from hydration and food issues. With covid I was almost constantly crashing and. i felt I had to eat/ drink juice constantly also to help my pain. TG I did not come anywhere near a dka.
The items that stuck out for me, reading the studies, was
The young age of the COVID positive and the COVID symptom groups, although maybe this has more to do with the sample than with the actual incidence
That quarantine improved control, so in one study it was reduced hypoglycemia, and the other numerous metrics were improved
The latter jibes with my own experience, in that my diet and control are generally better, but I am only now getting back to the same time and intensity for my workouts. I still can’t recover all the walking I did to/from work and during weekends.